Maximizing Your Organization's Impact: Integrating Behavioral Health Services

Enhancing Value-Based Care: Why Integrating Contracted Behavioral Health Services is Essential

The shift towards value-based care (VBC) is transforming healthcare. Instead of being reimbursed for the volume of services provided (fee-for-service), providers are increasingly rewarded for the quality and outcomes of care, focusing on improving patient health while controlling costs. This shift necessitates a more holistic and integrated approach, and behavioral health is a critical component that can no longer be overlooked. Integrating a contracted behavioral health service provider for skilled nursing facilities (SNFs), medical practices, and addiction recovery treatment centers is essential for success in a VBC environment.

Why Integrated Behavioral Health is Crucial for Value-Based Care

The rationale for integrating behavioral health services is multifaceted and strongly supported by research:

1. Improved Patient Outcomes:

   • Comorbidity: Mental health conditions frequently co-occur with physical illnesses and substance use disorders. For example, depression is highly prevalent among individuals with chronic conditions like diabetes, heart disease, and chronic pain. (Katon, 2011) Addressing these co-occurring conditions concurrently leads to better overall health outcomes, reduced hospital readmissions, and improved adherence to treatment plans.

   • Substance Use and Physical Health: Substance use disorders significantly impact physical health, increasing the risk of various medical complications. Integrated treatment addressing both substance use and medical issues is crucial for effective recovery.

   • Recovery and Rehabilitation: In SNFs and addiction recovery centers, behavioral health support is critical for promoting successful rehabilitation, preventing relapse, and fostering long-term well-being.

2. Reduced Healthcare Costs:

   • Emergency Department (ED) Utilization: Untreated mental health conditions often lead to increased ED visits and hospitalizations, driving up healthcare costs. Integrated behavioral health services can help identify and manage these conditions proactively, reducing the need for crisis interventions. (HHS.gov)

   • Medication Adherence: Individuals with untreated mental health conditions are less likely to adhere to their medication regimens for physical health conditions. This can lead to complications and increased healthcare utilization.

   • Chronic Disease Management: Integrated behavioral health can improve self-management of chronic diseases, leading to better health outcomes and lower costs.

3. Meeting VBC Metrics and Incentives:

   • Quality Measures: Many VBC programs include quality measures related to mental health screening, depression management, and substance use treatment. Integrating behavioral health services is essential for meeting these metrics and achieving financial incentives.

   • Patient Satisfaction: Addressing patients' mental and emotional well-being is crucial for improving patient satisfaction, a key component of many VBC programs.

   • Risk Stratification: Behavioral health providers can assist in identifying high-risk patients who may benefit from more intensive interventions, allowing for a more effective allocation of resources.

4. Enhanced Care Coordination.

   • Care coordination has been shown to be effective in reducing hospital admissions, driving patient engagement, and is considered cost-effective. (Bernstein et al., 2022)

Why Contract with an Outside Provider?

While building an in-house behavioral health team might seem appealing, contracting with an external provider often offers significant advantages, especially in the context of VBC:

• Specialized Expertise: Contracted providers often have specialized expertise in specific areas, such as trauma-informed care, geriatric mental health, or medication-assisted treatment (MAT) for opioid use disorder. This ensures patients receive the most appropriate and effective care.

• Scalability and Flexibility: Contracted services can be easily scaled up or down based on patient needs, providing flexibility that is difficult to achieve with an in-house team. This is particularly important in response to fluctuating patient volumes or changing program requirements.

• Cost-Effectiveness: Contracting can be more cost-effective than hiring and maintaining a full-time in-house team, especially for smaller facilities or practices. It avoids overhead costs associated with salaries, benefits, training, and office space.

• Reduced Administrative Burden: The contracted provider handles staffing, training, supervision, and compliance, freeing up administrative resources within the primary organization.

• Access to a Wider Network: Contracted providers often have established relationships with other community resources, such as support groups, housing programs, and vocational services, facilitating referrals and comprehensive care.

• Technology and Data Analytics: Many specialized behavioral health providers utilize advanced technology platforms for telehealth, remote patient monitoring, and data analytics. This can enhance care delivery, track outcomes, and demonstrate value to payers.

Specific Examples by Setting:

• Skilled Nursing Facilities (SNFs): Residents in SNFs often have complex medical and psychosocial needs, including high rates of depression, anxiety, and cognitive impairment. A contracted behavioral health provider can offer individual and group therapy, cognitive behavioral therapy (CBT) for pain management, and support for family caregivers. This can improve quality of life, reduce the use of antipsychotic medications, and lower rehospitalization rates.

• Medical Practices: Integrating behavioral health into primary care can improve the management of chronic diseases, address mental health conditions that often go undiagnosed, and promote overall patient well-being. Contracted providers can offer brief interventions, counseling, and medication management for common mental health conditions.

• Addiction Recovery Treatment Centers: Behavioral health is at the core of addiction treatment. A contracted provider can offer a range of evidence-based therapies, such as individual and group counseling, family therapy, trauma-informed care, and relapse prevention planning. They can also provide expertise in MAT and co-occurring disorder treatment.

Conclusion: A Strategic Investment in Value-Based Care

Integrating a contracted behavioral health service provider is not just an added expense; it's a strategic investment in improving patient outcomes, reducing costs, and succeeding in the value-based care landscape. By partnering with a specialized provider, SNFs, medical practices, and addiction recovery treatment centers can enhance the quality of care, meet VBC requirements, and ultimately improve the lives of the individuals they serve.

References:

• Bernstein, R., Chen, C., Pan, I. C., Rdesinski, R. E., & Rudowitz, R. (2022). Care Coordination for People with Behavioral Health Conditions. KFF. Retrieved from: https://www.kff.org/medicaid/issue-brief/care-coordination-for-people-with-behavioral-health-conditions/

• Katon, W. J. (2011). Epidemiology and treatment of depression in patients with chronic medical illness. Dialogues in clinical neuroscience, 13(1), 7.

• Substance Abuse and Mental Health Services Administration (SAMHSA). (n.d.). Value-Based Care. Retrieved from: https://www.samhsa.gov/ (SAMHSA is a reliable source for information on behavioral health and VBC.)

• US Department of Health and Human Services (HHS.gov)

Disclaimer: This blog post is for informational purposes only and does not constitute legal or medical advice. Consult with relevant professionals for specific guidance on implementing behavioral health services in your setting.